Provider Demographics
NPI:1326209024
Name:BHATIA, SUPRIYA KUMARI (MD)
Entity Type:Individual
Prefix:DR
First Name:SUPRIYA
Middle Name:KUMARI
Last Name:BHATIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780567 CALIFORNIA PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68178-0567
Mailing Address - Country:US
Mailing Address - Phone:402-280-2256
Mailing Address - Fax:
Practice Address - Street 1:780567 CALIFORNIA PLZ
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68178-0012
Practice Address - Country:US
Practice Address - Phone:402-280-2256
Practice Address - Fax:402-280-1589
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1101682084P0800X
ORMD1572452084P0800X
NE291982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry